Abstract

This study investigated the relationship between experiential avoidance, coping and the recency and frequency of self-harm, in a community sample (N = 1332, aged 16–69 years). Participants completed online, self-report measures assessing self-harm, momentary affect, experiential avoidance and coping in response to a recent stressor. Participants who had self-harmed reported significantly higher levels of experiential avoidance and avoidance coping, as well as lower levels of approach, reappraisal and emotional regulation coping, than those with no self-harm history. Moreover, more recent self-harm was associated with lower endorsement of approach, reappraisal and emotion regulation coping, and also higher levels of both avoidance coping and experiential avoidance. Higher experiential avoidance and avoidance coping also predicted increased lifetime frequency of self-harm. Conversely, increased approach and reappraisal coping were associated with a decreased likelihood of high frequency self-harm. Although some of the effects were small, particularly in relation to lifetime frequency of self-harm, overall our results suggest that experiential avoidance tendency may be an important psychological factor underpinning self-harm, regardless of suicidal intent (e.g. including mixed intent, suicidal intent, ambivalence), which is not accounted for in existing models of self-harm.

Highlights

  • Self-harm, defined as “self-injury or self-poisoning irrespective of the apparent purpose of the act” [1], is a major public health concern [2]

  • The findings support the hypothesis that those who have engaged in self-harm show significantly higher endorsement of experiential avoidance tendencies, than those who have never self-harmed

  • This remains the case when experiential avoidance and coping functions are entered into multivariate analyses, adjusted for age and affect

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Summary

Introduction

Self-harm, defined as “self-injury or self-poisoning irrespective of the apparent purpose of the act” [1], is a major public health concern [2]. As well as being indicative of serious psychological distress [3], self-harm is related to an increased rate of attempted suicide and death by suicide [4]. Self-harm is highly prevalent, with onset typically occurring in adolescence [5,6]. Given the high risk of repetition [7] and negative outcomes associated with escalation of these behaviours, it is important to explore the dynamics underlying self-harm, and in particular what might drive and break cyclical re-engagement in this behaviour. Experiential avoidance has been proposed as a central component in this [8].

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